Okay Cervies, here's one for you

[Jim M2]

Now about these results

FINDINGS... C7-T1:... The left C7 and T1 facets adjacent to the joint show increased T2 and decreased T1 signal consistent with inflammatory, edematous or reactive marrow changes.

IMPRESSIONS:
1. C7-T1 ... The left C7 and T1 facets adjacent to the joint show inflammatory, edematous or reactive marrow changes. A facet joint fracture cannot be entirely excluded as MR is relatively insensitive to cortical bone. If the patient has pain localized to this region, consideration may be given to thin section CT to rule out fracture.

My observation
I do have lower cervical left side component of pain (C7-T1?). Among other things it keeps me from making certain motions especially when exercising. It's probably not my chief complaint (my chief complaint is chronic DDD pain and ever more frequent arm pain). Consider these scenarios.

I choose not to have a CT.
I have thin section CT, it doesn't show fracture.
I have thin section CT, it shows fracture.

What treatments, therapies, additional diagnostics etc could possibly apply?
What would you do?

Let me know if you have any experience or thoughts on this.

Many thanks,

[Maria]

I would probably go with the CT scan to rule out the fracture and esp. if there is something that can be done regarding a fracture or even just for a broader diagnostic view.

I guess Mark can really answer your question in terms of what could be shown and if the CT scan is warrented.

I don't take CT scanning lightly but if it might show something that can be treated or be utilized further in terms of overall diagnostics I'd likely do it.

[Jim M2]

Maria,
I guess my question to them is "if there's a fracture what can be done?" I strongly suspect nothing can be done. I do like the idea of diagnostics. It's always good to know as much as possible. I cancelled the followup appointment with the NS, now I'd kind of like to know what she would say. I'm in no rush, I'll see what the forums say. I'm 99% sure there's nothing to be done.